Individual provider Active NPI

Mayya Munarova

  • Obstetrics & Gynecology Physician
  • Rego Park, NY
National Provider Identifier
1770520579
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
231069 Issued in NY
Practice address
9811 Queens Blvd
Rego Park, NY 11374-3323
Phone
(718) 606-2800
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 231069 NY Primary

Addresses

Primary practice location

9811 Queens Blvd
Rego Park, NY 11374-3323

Mailing address

9811 Queens Blvd
Suite LL3
Rego Park, NY 11374-3338
Phone (718) 606-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040407000316 NY Practitioner - Obstetrics/Gynecology 9638162431 Reassigns benefits to 2 organizations
Practice locations: Rego Park, NY

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9811 Queens Blvd
Suite LL3
Rego Park, NY 11374-3323
Phone (718) 606-2800

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
231069NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince May 1, 2015 Accepting new patients
Onsite Medical Suite PC CurrentSince Feb 25, 2016 Accepting new patients
North Shore-Lij Medical PC Obstetrics & Gynecology CurrentSince May 1, 2015 Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients

Locations

21902 Linden Blvd
Cambria Hts, NY 11411
Phone (718) 527-2850

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

9811 Queens Blvd
Ste LL3
Rego Park, NY 11374
Phone (718) 606-2800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1770520579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 QUEENS BLVD",
            "address_2": "SUITE LL3",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743338",
            "telephone_number": "718-606-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743323",
            "telephone_number": "718-606-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNAROVA",
        "first_name": "MAYYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "231069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.